Editing In vitro fertilisation (section)

==Controversial cases==
===Mix-ups===
In some cases, laboratory mix-ups (misidentified gametes, transfer of wrong embryos) have occurred, leading to legal action against the IVF provider and complex paternity suits. An example is the case of a woman in California who received the embryo of another couple and was notified of this mistake after the birth of her son.<ref>{{Cite journal| vauthors = Ayers C | title=Mother wins $1m for IVF mix-up but may lose son| journal = The Times | year=2004 | url=http://www.timesonline.co.uk/tol/news/world/article465773.ece | archive-url=https://web.archive.org/web/20070208101932/http://www.timesonline.co.uk/tol/news/world/article465773.ece | url-status=dead | archive-date=8 February 2007 }}</ref> This has led to many authorities and individual clinics implementing procedures to minimise the risk of such mix-ups. The [[HFEA]], for example, requires clinics to use a double witnessing system, the identity of specimens is checked by two people at each point at which specimens are transferred. Alternatively, technological solutions are gaining favour, to reduce the manpower cost of manual double witnessing, and to further reduce risks with uniquely numbered [[RFID]] tags which can be identified by readers connected to a computer. The computer tracks specimens throughout the process and alerts the embryologist if non-matching specimens are identified. Although the use of RFID tracking has expanded in the US,<ref>{{cite web|title=Reproductive Clinic Uses RFID to Guarantee Parental Identity|url=http://www.rfidjournal.com/articles/view?3683|archive-url=https://archive.today/20130616002649/http://www.rfidjournal.com/articles/view?3683|url-status=dead|archive-date=16 June 2013| vauthors = Swedberg C |date=15 October 2007|work=RFID Journal}}</ref> it is still not widely adopted.<ref>{{cite book|title=Vertauschte Keimzellen und Embryonen – Analyse reproduktionsmedizinischer Zwischenfälle: Normkontext, Rechtsfolgen, Regelungsbedarf|url=http://www.mohrsiebeck.com/en/book/vertauschte-keimzellen-und-embryonen-9783161591822?no_cache=1| vauthors = Jäschke ML | chapter=Vertauschte Keimzellen und Embryonen |work=Mohr Siebeck 2020|series = Studien zum Medizin- und Gesundheitsrecht|year = 2020|volume = 2| pages=1–376 |publisher = Mohr Siebeck|isbn = 9783161591822}}</ref>

===Preimplantation genetic diagnosis or screening ===
[[Preimplantation genetic diagnosis|Pre-implantation genetic diagnosis]] (PGD) is criticised for giving select demographic groups disproportionate access to a means of creating a child possessing characteristics that they consider "ideal". Many fertile couples<ref>{{cite journal |vauthors=Stern HJ |date=March 2014 |title=Preimplantation Genetic Diagnosis: Prenatal Testing for Embryos Finally Achieving Its Potential |journal=Journal of Clinical Medicine |volume=3 |issue=1 |pages=280–309 |doi=10.3390/jcm3010280 |pmc=4449675 |pmid=26237262 |doi-access=free}}</ref><ref>{{Cite web |title=Fertility is an Equal-Opportunity Issue for Couples – Penn Medicine |url=https://www.pennmedicine.org/updates/blogs/fertility-blog/2017/july/fertility-equality |access-date=31 August 2020 |website=www.pennmedicine.org |language=en-US}}</ref> now demand equal access to embryonic screening so that their child can be just as healthy as one created through IVF.  Mass use of PGD, especially as a means of [[population control]] or in the presence of legal measures related to population or demographic control, can lead to intentional or [[Unintended consequences|unintentional]] demographic effects such as the skewed live-birth sex ratios seen in China following implementation of its [[one-child policy]].

While PGD was originally designed to screen for embryos carrying hereditary genetic diseases, the method has been applied to select features that are unrelated to diseases, thus raising ethical questions. Examples of such cases include the selection of embryos based on [[histocompatibility]] (HLA) for the donation of tissues to a sick family member, the diagnosis of genetic susceptibility to disease, and [[sex selection]].<ref>{{cite journal | vauthors = Damian BB, Bonetti TC, Horovitz DD | title = Practices and ethical concerns regarding preimplantation diagnosis. Who regulates preimplantation genetic diagnosis in Brazil? | journal = Brazilian Journal of Medical and Biological Research = Revista Brasileira de Pesquisas Medicas e Biologicas | volume = 48 | issue = 1 | pages = 25–33 | date = January 2015 | pmid = 25493379 | pmc = 4288489 | doi = 10.1590/1414-431X20144083 }}</ref>

These examples raise ethical issues because of the morality of [[eugenics]]. It becomes frowned upon because of the advantage of being able to eliminate unwanted traits and selecting desired traits. By using PGD, individuals are given the opportunity to create a human life unethically and rely on science and not by [[natural selection]].<ref>{{cite journal | vauthors = Edwards RG | title = Ethics and moral philosophy in the initiation of IVF, preimplantation diagnosis and stem cells | journal = Reproductive Biomedicine Online | volume = 10 | issue = Suppl 1 | pages = 1–8 | date = March 2005 | pmid = 15819997 | doi = 10.1016/S1472-6483(10)62195-5 | name-list-style = vanc }}</ref>

For example, a deaf British couple, Tom and Paula Lichy, have petitioned to create a deaf baby using IVF.<ref>{{Cite news| vauthors = Lawson D |title=Of course a deaf couple want a deaf child|work=The Independent |date=11 March 2008|url=https://www.independent.co.uk/opinion/commentators/dominic-lawson/dominic-lawson-of-course-a-deaf-couple-want-a-deaf-child-794001.html|access-date=12 November 2009 | location=London}}</ref> Some [[bioethics|medical ethicists]] have been very critical of this approach. [[Jacob M. Appel]] wrote that "intentionally culling out blind or deaf embryos might prevent considerable future suffering, while a policy that allowed deaf or blind parents to select ''for'' such traits intentionally would be far more troublesome."<ref>{{cite report | vauthors = Appel J | date = 12 March 2009 | title = More 'designer' options. | work = The Winnipeg Sun }}</ref>

===Industry corruption===
Robert Winston, professor of fertility studies at Imperial College London, had called the industry "corrupt" and "greedy" stating that "one of the major problems facing us in healthcare is that IVF has become a massive commercial industry," and that "what has happened, of course, is that money is corrupting this whole technology", and accused authorities of failing to protect couples from exploitation: "The regulatory authority has done a consistently bad job. It's not prevented the exploitation of people, it's not put out very good information to couples, it's not limited the number of unscientific treatments people have access to".<ref>{{cite news| url=https://www.theguardian.com/science/2007/may/31/medicineandhealth.health | location= London | work = The Guardian  | vauthors = Jha A | title=Winston: IVF clinics corrupt and greedy | date= 31 May 2007}}</ref> The IVF industry has been described as a market-driven construction of health, medicine and the human body.<ref>{{Cite book| vauthors = Dumit J |title=Drugs for life : how pharmaceutical companies define our health|date=2012|publisher=Duke University Press|isbn=978-0-8223-4860-3|location=Durham, NC|oclc=782252371}}</ref>

The industry has been accused of making unscientific claims, and distorting facts relating to infertility, in particular through widely exaggerated claims about how common infertility is in society, in an attempt to get as many couples as possible and as soon as possible to try treatments (rather than trying to conceive naturally for a longer time).{{citation needed|date=January 2024}} This risks removing infertility from its social context and reducing the experience to a simple biological malfunction, which not only ''can'' be treated through bio-medical procedures, but should be treated by them.<ref>{{cite conference | vauthors = Dietrich H | date = May 1986 | title = IVF: what can we do? | conference = Liberation or Loss? | location = Canberra }}</ref><ref name="pmid11649236">{{cite journal | vauthors = Warren MA | title = IVF and women's interests: an analysis of feminist concerns | journal = Bioethics | volume = 2 | issue = 1 | pages = 37–57 | date = January 1988 | pmid = 11649236 | doi = 10.1111/j.1467-8519.1988.tb00034.x }}</ref>

=== Older patients ===
All pregnancies can be risky, but there are greater risk for mothers who are older and are over the age of 40. As people get older, they are more likely to develop conditions such as gestational diabetes and pre-eclampsia. If the mother does conceive over the age of 40, their offspring may be of lower birth weight, and more likely to requires intensive care. Because of this, the increased risk is a sufficient cause for concern. The high incidence of caesarean in older patients is commonly regarded as a risk.<ref>{{Cite journal |last1=Šťastná |first1=Anna |last2=Fait |first2=Tomáš |last3=Kocourková |first3=Jiřina |last4=Waldaufová |first4=Eva |date=2022-12-30 |title=Does Advanced Maternal Age Comprise an Independent Risk Factor for Caesarean Section? A Population-Wide Study |journal=International Journal of Environmental Research and Public Health |volume=20 |issue=1 |pages=668 |doi=10.3390/ijerph20010668 |doi-access=free |issn=1661-7827 |pmc=9819592 |pmid=36612987}}</ref>

Those conceiving at 40 have a greater risk of gestational hypertension and premature birth. The offspring is at risk when being born from older mothers, and the risks associated with being conceived through IVF.<ref>{{cite journal | vauthors = Smajdor A | title = The ethics of IVF over 40 | journal = Maturitas | volume = 69 | issue = 1 | pages = 37–40 | date = May 2011 | pmid = 21435805 | doi = 10.1016/j.maturitas.2011.02.012 | name-list-style = vanc }}</ref>
[[File:Vaginal Canal Normal vs. Menopause.png|thumb|premenopausal vaginal canal vs menopausal vaginal canal]]

[[Adriana Iliescu]] held the record for a while as the oldest woman to give birth using IVF and a donor egg, when she gave birth in 2004 at the age of 66.{{Citation needed|date=April 2023}} In September 2019, a  74-year-old woman became the oldest-ever to give birth after she delivered twins at a hospital in [[Guntur]], [[Andhra Pradesh]].<ref name="ndtv.com">{{Cite news|title = At 74, Andhra Woman Becomes The Oldest-Ever To Give Birth|url = https://www.ndtv.com/andhra-pradesh-news/at-74-andhra-woman-becomes-the-oldest-ever-to-give-birth-2096142?pfrom=home-topstories|newspaper = NDTV.com|date = 6 September 2019|access-date = 5 November 2015}}</ref>

==== Pregnancy after menopause ====
Although menopause is a natural barrier to further conception, IVF has allowed people to be pregnant in their fifties and sixties. People whose uteruses have been appropriately prepared receive embryos that originated from an egg donor. Therefore, although they do not have a genetic link with the child, they have a physical link through pregnancy and [[childbirth]]. Even after menopause, the uterus is fully capable of carrying out a pregnancy.<ref>{{cite journal | vauthors = Parks JA | title = A closer look at reproductive technology and postmenopausal motherhood | journal = CMAJ | volume = 154 | issue = 8 | pages = 1189–1191 | date = April 1996 | pmid = 8612255 | pmc = 1487687 }}</ref>

===Same-sex couples, single and unmarried parents===
{{See also|LGBT reproduction|LGBT parenting}}

A 2009 statement from the [[American Society for Reproductive Medicine|ASRM]] found no persuasive evidence that children are harmed or disadvantaged solely by being raised by single parents, unmarried parents, or homosexual parents. It did not support restricting access to assisted reproductive technologies on the basis of a prospective parent's marital status or sexual orientation.<ref name=asrm2009>{{cite journal | vauthors = ((The Ethics Committee of the American Society for Reproductive Medicine)) | title = Access to fertility treatment by gays, lesbians, and unmarried persons | journal = Fertility and Sterility | volume = 92 | issue = 4 | pages = 1190–1193 | date = October 2009 | pmid = 19732884 | doi = 10.1016/j.fertnstert.2009.07.977 | doi-access = free }}</ref> A 2018 study found that children's psychological well-being did not differ when raised by either same-sex parents or heterosexual parents, even finding that psychological well-being was better amongst children raised by same-sex parents.<ref>{{Cite journal | vauthors = Mechcatie E, Rosenberg K |date=November 2018 |title=No Detrimental Effects in Children of Same-Sex Parents |url=https://journals.lww.com/00000446-201811000-00028 |journal=American Journal of Nursing |language=en |volume=118 |issue=11 |pages=55 |doi=10.1097/01.NAJ.0000547663.85215.a6 |pmid=30358598 |s2cid=53028172 |issn=0002-936X|url-access=subscription }}</ref>

Ethical concerns include reproductive rights, the welfare of offspring, nondiscrimination against unmarried individuals, homosexual, and professional autonomy.<ref name=asrm2009/>

A controversy in California focused on the question of whether physicians opposed to same-sex relationships should be required to perform IVF for a lesbian couple. Guadalupe T. Benitez, a lesbian medical assistant from San Diego, sued doctors Christine Brody and Douglas Fenton of the North Coast Woman's Care Medical Group after Brody told her that she had "religious-based objections to treating her and homosexuals in general to help them conceive children by artificial insemination," and Fenton refused to authorise a refill of her prescription for the fertility drug Clomid on the same grounds.<ref>{{cite journal | vauthors = Appel JM | title = May doctors refuse infertility treatments to gay patients? | journal = The Hastings Center Report | volume = 36 | issue = 4 | pages = 20–21 | year = 2006 | pmid = 16898357 | doi = 10.1353/hcr.2006.0053 | s2cid = 39694945 }}</ref><ref>{{cite web|date=29 May 2008|title=State high court may give gays another victory|url=https://www.latimes.com/news/local/la-me-doctor29-2008may29,0,592068.story|vauthors=Dolan M|work=Los Angeles Times}}</ref> The California Medical Association had initially sided with Brody and Fenton, but the case, ''[[North Coast Women's Care Medical Group v. Superior Court]]'', was decided unanimously by the California State Supreme Court in favour of Benitez on 19 August 2008.<ref>{{cite web | vauthors = Goldstein J | date = 19 August 2008 | url = https://blogs.wsj.com/health/2008/08/19/california-doctors-cant-refuse-care-to-gays-on-religious-grounds/ | title = California Doctors Can't Refuse Care to Gays on Religious Grounds | work = Wall Street Journal }}</ref><ref name="Bob Egelko 2008">{{cite web | vauthors = Egelko B | date = 19 August 2008 | title = Bob Doctors can't use bias to deny gays treatment | work = San Francisco Chronicle | url = https://www.sfgate.com/health/article/Doctors-can-t-use-bias-to-deny-gays-treatment-3199719.php }}</ref>

[[Nadya Suleman]] came to international attention after having twelve embryos implanted, eight of which survived, resulting in eight newborns being added to her existing six-child family. The Medical Board of California sought to have fertility doctor Michael Kamrava, who treated Suleman, stripped of his licence. State officials allege that performing Suleman's procedure is evidence of unreasonable judgment, substandard care, and a lack of concern for the eight children she would conceive and the six she was already struggling to raise. On 1 June 2011 the Medical Board issued a ruling that Kamrava's medical licence be revoked effective 1 July 2011.<ref>{{cite news |url= https://www.boston.com/news/nation/articles/2010/10/25/license_hearing_for_octomom_doctor_resumes_in_la/| vauthors = Mohajer ST |title=License hearing for Octomom doctor resumes in LA |agency=Associated Press|date=25 October 2010}}</ref><ref>{{cite web | vauthors = Breuer H |url=http://www.people.com/people/article/0,,20436389,00.html |title=Octomom's Doctor Tearfully Apologizes, Admits Mistake |work=People |date=22 October 2010 |access-date=22 May 2012 |archive-date=4 March 2016 |archive-url=https://web.archive.org/web/20160304082848/http://www.people.com/people/article/0,,20436389,00.html |url-status=dead }}</ref><ref>{{cite web |url=http://documents.latimes.com/michael-kamrava-disciplinary-decision/ |title=Michael Kamrava's medical license revoked|date=1 June 2011 |work=Los Angeles Times }}</ref>

=== Transgender parents ===
{{See also|Transgender pregnancy}}
The research on [[transgender]] reproduction and family planning is limited.<ref name="Besse2020">{{cite journal | vauthors = Besse M, Lampe NM, Mann ES | title = Experiences with Achieving Pregnancy and Giving Birth Among Transgender Men: A Narrative Literature Review | journal = The Yale Journal of Biology and Medicine | volume = 93 | issue = 4 | pages = 517–528 | date = September 2020 | pmid = 33005116 | pmc = 7513446 }}</ref> A 2020 comparative study of children born to a transgender father and cisgender mother via [[donor sperm insemination]] in France showed no significant differences to IVF and naturally conceived children of cisgender parents.<ref>{{cite journal | vauthors = Condat A, Mamou G, Lagrange C, Mendes N, Wielart J, Poirier F, Medjkane F, Brunelle J, Drouineaud V, Rosenblum O, Gründler N, Ansermet F, Wolf JP, Falissard B, Cohen D | display-authors = 6 | title = Transgender fathering: Children's psychological and family outcomes | journal = PLOS ONE | volume = 15 | issue = 11 | pages = e0241214 | date = 19 November 2020 | pmid = 33211742 | pmc = 7676740 | doi = 10.1371/journal.pone.0241214 | bibcode = 2020PLoSO..1541214C | doi-access = free }}</ref>

Transgender men can experience challenges in pregnancy and birthing from the cis-normative structure within the medical system,<ref name="Besse2020" /> as well as psychological challenges such as renewed gender dysphoria.<ref>{{harvnb|Obedin-Maliver|Makadon|2016|loc=§ "Psychological considerations"}}.</ref> The effect of continued testosterone therapy during pregnancy and breastfeeding is undetermined.<ref>{{harvnb|Obedin-Maliver|Makadon|2016|loc=§ "Fertility and achieving pregnancy"}}.</ref> Ethical concerns include reproductive rights, reproductive justice, physician autonomy, and transphobia within the health care setting.<ref name="Besse2020" />

===Anonymous donors===
{{Further|Donor conceived person}}
Alana Stewart, who was conceived using donor sperm, began an online forum for donor children called AnonymousUS in 2010. The forum welcomes the viewpoints of anyone involved in the IVF process.<ref name="AnonymousUS CT">{{cite web| vauthors = Scheller CA |title=The Untold Story of Donor-Conceived Children |url= http://blog.christianitytoday.com/women/2011/01/the_untold_story_of_spermdonor.html |work=Christianity Today|url-status=dead|archive-url= https://web.archive.org/web/20120718221959/http://blog.christianitytoday.com/women/2011/01/the_untold_story_of_spermdonor.html |archive-date=18 July 2012}}</ref> In May 2012, a court ruled making anonymous sperm and egg donation in British Columbia illegal.<ref name="BC Canada ruling">{{cite journal| vauthors = Motluk A |title=Canadian court bans anonymous sperm and egg donation|doi=10.1038/news.2011.329 |journal=Nature|date=27 May 2011}}</ref>

In the UK, Sweden, Norway, Germany, Italy, New Zealand, and some Australian states, donors are not paid and cannot be anonymous.{{Citation needed|date=April 2025}}

In 2000, a website called [[Donor Sibling Registry]] was created to help biological children with a common donor connect with each other.<ref name="IVF donor NPR">{{cite web|title='My Daddy's Name is Donor'|url=https://www.npr.org/templates/story/story.php?storyId=129233185|date=16 August 2010|work=NPR}}</ref><ref name="donor-conceived WP">{{cite news|title=Donor-conceived children use Internet to find relatives and share information|url=https://www.washingtonpost.com/national/health-science/donor-conceived-children-use-internet-to-find-relatives-and-share-information/2011/07/01/gIQA3BiwzK_story.html|newspaper=Washington Post|date=26 September 2011}}</ref>

===Leftover embryos or eggs, unwanted embryos ===
{{Further|Embryo donation|Egg donor}}
There may be leftover embryos or eggs from IVF procedures if the person for whom they were originally created has successfully carried one or more pregnancies to term, and no longer wishes to use them. With the patient's permission, these may be donated to help others conceive by means of [[third party reproduction]].

In [[embryo donation]], these extra embryos are given to others for [[Embryo transfer|transfer]], with the goal of producing a successful pregnancy. Embryo recipients have genetic issues or poor-quality embryos or eggs of their own. The resulting child is considered the child of whoever birthed them, and not the child of the donor, the same as occurs with [[egg donor|egg donation]] or [[sperm donation]]. As per The National Infertility Association, typically, genetic parents donate the eggs or embryos to a [[fertility clinic]] where they are preserved by [[oocyte cryopreservation]] or [[embryo cryopreservation]] until a carrier is found for them. The process of matching the donation with the prospective parents is conducted by the agency itself, at which time the clinic transfers ownership of the embryos to the prospective parent(s).<ref>{{cite web | url = http://familybuilding.resolve.org/site/PageServer?pagename=lrn_wamo_pd&JServSessionId_form=login&printer_friendly=1 | title = Donor Embryo: Online Guide for Potential Donors | publisher = RESOLVE  | access-date = 3 August 2013 | archive-date = 19 February 2013 | archive-url = https://web.archive.org/web/20130219103234/http://familybuilding.resolve.org/site/PageServer?pagename=lrn_wamo_pd&JServSessionId_form=login&printer_friendly=1 | url-status = dead }}</ref>

Alternatives to donating unused embryos are destroying them (or having them [[embryo transfer|transferred]] at a time when pregnancy is very unlikely),<ref name="cnn.com">{{cite web | vauthors = Beil L | date = 1 September 2009 | url = http://www.cnn.com/2009/HEALTH/09/01/extra.ivf.embryos/ | title = What happens to extra embryos after IVF? | work = CNN }}</ref> keeping them frozen indefinitely, or donating them for use in research (rendering them non-viable).<ref>{{cite journal | vauthors = Douglas T, Savulescu J | title = Destroying unwanted embryos in research. Talking Point on morality and human embryo research | journal = EMBO Reports | volume = 10 | issue = 4 | pages = 307–312 | date = April 2009 | pmid = 19337299 | pmc = 2672894 | doi = 10.1038/embor.2009.54 }}</ref> Individual moral views on disposing of leftover embryos may depend on personal views on the [[beginning of human personhood]] and the definition and/or value of [[potential person|potential future persons]], and on the value that is given to fundamental research questions. Some people believe donation of leftover embryos for research is a good alternative to discarding the embryos when patients receive proper, honest and clear information about the research project, the procedures and the scientific values.<ref>{{cite journal | vauthors = Hug K | title = Motivation to donate or not donate surplus embryos for stem-cell research: literature review | journal = Fertility and Sterility | volume = 89 | issue = 2 | pages = 263–277 | date = February 2008 | pmid = 18166188 | doi = 10.1016/j.fertnstert.2007.09.017 }}</ref>

During the [[embryo selection]] and transfer phases, many embryos may be discarded in favour of others. This selection may be based on criteria such as genetic disorders or the sex. One of the earliest cases of special gene selection through IVF was the case of the Collins family in the 1990s, who selected the sex of their child.<ref>{{cite journal | vauthors = Lemonick MD | date = 1999 | url = http://content.time.com/time/magazine/article/0,9171,17696,00.html/ | title = Designer Babies | archive-url = https://web.archive.org/web/20160308081926/http://content.time.com/time/magazine/article/0,9171,17696,00.html | archive-date=8 March 2016 | journal = Time Magazine | volume = 153 | issue = 1 | pages = 64–67 | pmid = 11656968 }}</ref>

The ethic issues remain unresolved as no worldwide consensus exists in science, religion, and philosophy on when a human embryo should be recognised as a person. For those who believe that this is at the moment of conception, IVF becomes a moral question when multiple eggs are fertilised, begin development, and only a few are chosen for uterus transfer.{{Citation needed|date=March 2017}}
If IVF were to involve the fertilisation of only a single egg, or at least only the number that will be [[embryo transfer|transferred]], then this would not be an issue. However, this has the chance of increasing costs dramatically as only a few eggs can be attempted at a time.  As a result, the couple must decide what to do with these extra embryos. Depending on their view of the embryo's humanity or the chance the couple will want to try to have another child, the couple has multiple options for dealing with these extra embryos. Couples can choose to keep them frozen, donate them to other infertile couples, thaw them, or donate them to medical research.<ref name="cnn.com"/> Keeping them frozen costs money, donating them does not ensure they will survive, thawing them renders them immediately unviable, and medical research results in their termination. In the realm of medical research, the couple is not necessarily told what the embryos will be used for, and as a result, some can be used in [[stem cell]] research.

In February 2024, the [[Alabama Supreme Court]] ruled in ''[[LePage v. Center for Reproductive Medicine]]'' that cryopreserved embryos were "persons" or "extrauterine children". After [[Dobbs v. Jackson Women's Health Organization]] (2022), some antiabortionists had hoped to get a judgement that fetuses and embryos were "person[s]".<ref>{{Cite journal |last1=Feinberg |first1=Rebecca S. |last2=Sinha |first2=Michael S. |last3=Cohen |first3=I. Glenn |date=2024-03-04 |title=The Alabama Embryo Decision—The Politics and Reality of Recognizing "Extrauterine Children" |url=https://doi.org/10.1001/jama.2024.3559 |journal=JAMA |volume=331 |issue=13 |pages=1083–1084 |doi=10.1001/jama.2024.3559 |pmid=38436995 |issn=0098-7484|url-access=subscription }}</ref>

===Religious response===
{{Main|Religious response to assisted reproductive technology}}

====Christianity====
The [[Catholic Church]] opposes all kinds of [[assisted reproductive technology]] and artificial [[contraception]], on the grounds that they separate the procreative goal of [[Sacraments of the Catholic Church#Matrimony|marital sex]] from the goal of uniting married couples.
The Catholic Church permits the use of a small number of reproductive technologies and contraceptive methods such as [[natural family planning]], which involves charting ovulation times, and allows other forms of reproductive technologies that allow conception to take place from normative sexual intercourse, such as a fertility lubricant. Pope Benedict XVI had publicly re-emphasised the Catholic Church's opposition to in vitro fertilisation, saying that it replaces love between a husband and wife.<ref>{{Citation|newspaper=Medical news today |url=http://www.medicalnewstoday.com/articles/38686.php |title=Pope Benedict XVI Declares Embryos Developed For In Vitro Fertilization Have Right To Life |url-status=dead |archive-url=https://web.archive.org/web/20081229164506/http://www.medicalnewstoday.com/articles/38686.php |archive-date=29 December 2008  }}</ref> The Catechism of the Catholic Church, in accordance with the Catholic understanding of [[Natural law#Catholic natural law jurisprudence|natural law]], teaches that reproduction has an "inseparable connection" to the sexual union of married couples.<ref>{{cite web | location = Rome  | url = https://www.vatican.va/holy_father/paul_vi/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae_en.html | title = Humanae Vitae: Encyclical of Pope Paul VI on the Regulation of Birth, sec 12| author = Pope Paul VI | author-link = Pope Paul VI|date= 25 July 1968|access-date= 25 November 2008|publisher = Vatican}}</ref> In addition, the church opposes IVF because it might result in the disposal of embryos; in Catholicism, an embryo is viewed as an individual with a [[soul]] that must be treated as a person.<ref name=medill>{{cite web | url = http://news.medill.northwestern.edu/chicago/news.aspx?id=136743 | title = Reconciling religion and infertility | archive-url = https://web.archive.org/web/20131104194217/http://news.medill.northwestern.edu/chicago/news.aspx?id=136743 | archive-date=4 November 2013 | vauthors = Dain A | date = 30 July 2009 }}</ref> The Catholic Church maintains that it is not objectively evil to be infertile, and advocates adoption as an option for such couples who still wish to have children.<ref name = "catechism">{{cite web| title = Catechism of the Catholic Church. Section 2377 | url = https://www.vatican.va/archive/ENG0015/__P86.HTM |access-date=25 November 2008|publisher = Vatican |year= 1993 | location = Rome}}</ref>

The [[Lutheran Council in the United States of America]], organised by the [[Lutheran Church–Missouri Synod]] and parent bodies of the [[Evangelical Lutheran Church in America]], produced an authoritative document on the issue of in-vitro fertilisation, which "unanimously concluded that IVF does not ''in and of itself'' violate the will of God as reflected in the Bible, when the wife’s egg and husband’s sperm are used" (LCUSA n.d.:31).<ref name="AbbottNelson2002">{{cite web |author1=Deborah Abbott |author2=Paul Nelson |title=The Lutheran Tradition: Religious Beliefs and Healthcare Decisions |url=https://www.advocatehealth.com/assets/documents/faith/lutheranfinal.pdf|archiveurl=https://web.archive.org/web/20210209023416/https://www.advocatehealth.com/assets/documents/faith/lutheranfinal.pdf|archivedate=9 February 2021|publisher=Park Ridge Center for the Study of Health, Faith, and Ethics |page=9 February 2021|language=English |date=2002}}</ref> The Lutheran Churches approve of artificial insemination by a husband (AIH), though representatives from the [[Lutheran Church-Missouri Synod]] hold that such IVF is only unobjectionable if the sperm and egg come from husband and wife and all of the fertilised eggs are implanted in the womb of the wife.<ref name="AbbottNelson2002"/> With regard to artificial insemination by a donor (AID), the Evangelical Lutheran Church in America teaches that it is a "cause for moral concern", while the [[Lutheran Church–Missouri Synod]] rejects it.<ref name="AbbottNelson2002"/>

====Islam====
Regarding the response to IVF by [[Islam]], a general consensus from the contemporary Sunni scholars concludes that IVF methods are immoral and prohibited. However, Gad El-Hak Ali Gad El-Hak's ART fatwa includes that:<ref>{{cite journal | vauthors = Inhorn MC | title = Making Muslim babies: IVF and gamete donation in Sunni versus Shi'a Islam | journal = Culture, Medicine and Psychiatry | volume = 30 | issue = 4 | pages = 427–450 | date = December 2006 | pmid = 17051430 | pmc = 1705533 | doi = 10.1007/s11013-006-9027-x | url = http://vlex.com/vid/fatwas-ivf-gamete-sunni-shia-islam-418643 | access-date = 3 November 2013 | url-status = dead | archive-url = https://web.archive.org/web/20090624121701/http://vlex.com/vid/fatwas-ivf-gamete-sunni-shia-islam-418643 | archive-date = 24 June 2009 }}</ref>
*IVF of an egg from the wife with the sperm of her husband and the transfer of the fertilised egg back to the uterus of the wife is allowed, provided that the procedure is indicated for a medical reason and is carried out by an expert physician.
*Since marriage is a contract between the wife and husband during the span of their marriage, no third party should intrude into the marital functions of sex and procreation. This means that a third party donor is not acceptable, whether he or she is providing sperm, eggs, embryos, or a uterus. The use of a third party is tantamount to ''zina'', or [[adultery]].

====Judaism====
Within the [[Orthodox Judaism|Orthodox Jewish]] community the concept is debated as there is little precedent in traditional Jewish legal textual sources. Regarding [[Judaism and sexuality|laws of sexuality]], religious challenges include [[masturbation]] (which may be regarded as "seed wasting"<ref name=medill/>), laws related to sexual activity and menstruation ([[niddah]]) and the specific laws regarding intercourse. An additional major issue is that of establishing paternity and lineage. For a baby conceived naturally, the father's identity is determined by a legal presumption ([[chazakah]]) of legitimacy: ''rov bi'ot achar ha'baal'' – a woman's [[Human sexual behavior|sexual relations]] are assumed to be with her husband. Regarding an IVF child, this assumption does not exist and as such Rabbi [[Eliezer Waldenberg]] (among others) requires an outside supervisor to positively identify the father.<ref>Tzitz Eliezer 9 p. 247</ref> [[Reform Judaism]] has generally approved IVF.<ref name="medill"/>

===Society and culture===

Many women of sub-Saharan Africa choose to foster their children to infertile women. IVF enables these infertile women to have their own children, which imposes new ideals to a culture in which fostering children is seen as both natural and culturally important. Many infertile women are able to earn more respect in their society by taking care of the children of other mothers, and this may be lost if they choose to use IVF instead. As IVF is seen as unnatural, it may even hinder their societal position as opposed to making them equal with fertile women. It is also economically advantageous for infertile women to raise foster children as it gives these children greater ability to access resources that are important for their development and also aids the development of their society at large. If IVF becomes more popular without the birth rate decreasing, there could be more large family homes with fewer options to send their newborn children. This could result in an increase of orphaned children and/or a decrease in resources for the children of large families. This would ultimately stifle the children's and the community's growth.<ref>{{cite journal | vauthors = Drah B | title = Orphans in Sub-Saharan Africa: The Crisis, the Interventions, and the Anthropologist | journal = Africa Today | volume = 59 | issue = 2 (Winter2012 2012) | pages = 3–21 | doi=10.2979/africatoday.59.2.3| year = 2012 | s2cid = 144808526 }}</ref>

In the US, the [[pineapple]] has emerged as a symbol of IVF users, possibly because some people thought, without scientific evidence, that eating pineapple might slightly increase the success rate for the procedure.<ref>{{Cite news|url=https://www.nytimes.com/2019/10/02/style/pineapple-in-vitro-fertilization-pregnancy.html|title=How the Pineapple Became the Icon of I.V.F.| vauthors = Lorenz T |date=2 October 2019|work=The New York Times|access-date=4 October 2019|language=en-US|issn=0362-4331}}</ref>